No abstract

No abstract

No abstract

No abstract

Cancer investigation targets are set nationally with current 14 day referral to review and 62 days to treatment. Nationally and locally there has been difficulty meeting these current standards and timescales are being revised with published NHS strategy 2015–20 (28 days referral-treatment plan). Wirral University Hospital is a large non-tertiary trust who diagnosed a total of 341 lung cancers in 2015, 147 following GP urgent referrals (total 547 referrals) Previously we ran a traditional “one stop” weekly clinic with CT scan, review and same day endoscopy. Study of delayed pathways highlighted problems- lack of same day “best test”, delay of arranging PET/physiology testing and anticoagulation/sedation issues were preventing same day investigations. In September 2015 we changed to a daily virtual review clinic post CT (day 5–7). First patient contact is via telephone call from CNS to explain further investigations and give contact details. We audited 3 months diagnoses following primary care referrals Sept-Nov 2015 vs 2014 and completed patient satisfaction questionnaire post diagnosis on communication and perceived management. Results- Diagnoses – 38 (2014)/36 (2015). 2015 showed reduction in average investigations (1.4 vs 1.18); outpatient attendances (2.4 vs 1.75); time to PET-CT (19.8 vs 15.7 days) and total radiological diagnoses (7 vs 3). There was no reduction in median time to diagnosis (20 vs 21 days) but less variance in pathways with shorter range. On survey 16/18 of patients rated the care/communication as excellent. For the 36 new diagnoses post implementation we saved equivalent of 23 follow-up appointments and 9 invasive investigations (equating £30,000/year savings) within the group diagnosed with cancer. We feel the change from traditional one-stop outpatient clinics to a more individual case based management with virtual review and non-OPD based communication is essential to develop lung cancer pathways and would advise other units to adopt similarAbstract P263 Figure 1